Late-Stage Breast Cancer Diagnosis and Health Care Access in Illinois∗

The variations of breast cancer mortality rates from place to place reflect both underlying differences in breast cancer prevalence and differences in diagnosis and treatment that affect the risk of death. This article examines the role of access to health care in explaining the variation of late-stage diagnosis of breast cancer. We use cancer registry data for the state of Illinois by zip code to investigate spatial variation in late diagnosis. Geographic information systems and spatial analysis methods are used to create detailed measures of spatial access to health care such as convenience of visiting primary care physicians and travel time from the nearest mammography facility. The effects of spatial access, in combination with the influences of socioeconomic factors, on late-stage breast cancer diagnosis are assessed using statistical methods. The results suggest that for breast cancer, poor geographical access to primary health care significantly increases the risk of late diagnosis for persons living outside the city of Chicago. Disadvantaged population groups including those with low income and racial and ethnic minorities tend to experience high rates of late diagnosis. In Illinois, poor spatial access to primary health care is more strongly associated with late diagnosis than is spatial access to mammography. This suggests the importance of primary care physicians as gatekeepers in early breast cancer detection.     

Measuring Space–Time Access to Food Retailers: A Case of Temporal Access Disparity in Franklin County,Ohio

Typical measures of food access use spatial-only methods to identify nearby food outlets and the quantity, quality, and variety of food available. This measure of spatial access falls short in explaining the effect that the operating hours of food retailers have on food access. Our study aims to complement the spatial dimension of access measures by bringing time in as a new constraint on food access. To this end, we developed three measures of spatial, temporal, and spatiotemporal access and correlated these measures with socioeconomic status (SES) in a case in Columbus, Ohio. Findings from our analysis of food access disparity suggest that low-SES neighborhoods in Columbus are not at a disadvantage of spatial access, but their limited temporal access is a more pressing concern. Implications drawn from the study would assist community advocates, local governments, and other stakeholders in deriving a better understanding of the local foodscape that are not only mediated by space but also time.     

PM2.5污染对中国人口死亡率的影响——基于346个城市面板数据的实证分析

中国生态文明建设和“健康中国”战略强调切实治理影响人口健康的环境问题,建设健康人居环境。论文基于2000年和2010年中国人口普查资料以及2005年和2015年各省级行政单元1%人口抽样调查等数据资料,论文使用探索性空间分析方法刻画中国城市人口死亡率的时空变化特征,并采用空间回归方法,揭示城市PM_2.5的平均浓度对人口死亡率的影响及其空间溢出效应,以及社会经济因素对PM_2.5—人口死亡率关联的调节效应。结果表明：① 中国城市人口死亡率的空间分布特征呈现明显的异质性,高死亡率地区早期集聚分布于西南地区,2005年后在西南地区、华北地区、华东地区和华中地区呈现逐渐集聚分布态势。低死亡率地区长期集中分布于西北地区、东北地区、长三角地区、珠三角地区和京津两市。② 人口死亡率的分布存在空间关联性,高—高类型地区早期集中分布于西南地区,后期向东扩展;低—低类型地区主要分布于北疆、内蒙古西部和广东省及其周边地区。③ 城市PM_2.5浓度对人口死亡率具有显著的正向影响,并且对邻近地区的人口死亡率具有显著的空间溢出效应。④ 中国城市PM_2.5浓度对人口死亡率的影响存在学历差异和城乡差异,地区高学历人群集聚可降低PM_2.5的健康风险,城镇化发展进程缓慢则会加重PM_2.5的健康风险。研究旨在为防范空气污染暴露导致的健康风险、建设健康人居环境提供科学依据。     

Analysis of food retail patterns in urban,peri-urban and rural settings: A case study from Lebanon

Existing evidence on food retail expansion in developing countries is largely based on cross-country studies. This may be excellent to provide general pictures but less relevant for development planners to tailor context-specific interventions. We apply a meso-level analysis to address three questions: (i) Are modern food retail formats impeding the expansion of the traditional ones? (ii) What is the pattern of food retail expansion into urban, peri-urban, and rural areas? (iii) What factors influence observed food retail patterns? The study was carried out within the geographic landscape of Lebanon, a commercial link between the Middle East and Europe. Historical analysis shows increased growth both in the modern and traditional food retail sales, with the former modestly outpacing the latter. However, data from the last five years indicate the gap being reduced to 2 percentage points, displaying a clear leveling-off as compared to the preceding decade. Thus, we find insufficient evidence to conclude that modern food retail formats are definitively replacing traditional ones. An extremely high spatial disparity in food retail concentration is observed across governorates and districts, suggesting a need for flexible policies for viable food system development in various contexts. Expansion of modern food retail formats is limited by geography or socioeconomic groups, while traditional formats are equally present in urban, peri-urban and rural settings, including high poverty areas. This suggests a need for recognizing the latter as alternative institutions to address specific needs of consumers, particularly in poorer neighborhoods or rural areas. The findings are relevant for international, regional, and domestic food retailers to understand food retail patterns in Lebanon, for development planners to tailor specific interventions in areas where food establishments are least developed, and for researchers to investigate the impact of such patterns on nutritional transformations among the Lebanese urban, peri-urban and rural populations.     

京津冀地区经济发展的空间溢出效应

在实施京津冀协同发展战略的背景下,将修正的Conley-Ligon模型与空间马尔可夫链分析法相结合,探讨了京津冀县域经济发展过程中的溢出效应空间格局及其对经济水平空间格局演变的影响。研究发现：2000-2013年,京津冀地区的县域间存在显著的空间溢出效应,溢出效应在空间上呈现出与经济发展水平和空间距离紧密相关的具有梯次性特征的核心-外围结构,经济发达的地区发出正向溢出效应的同时也获取了正向溢出效应,但总体上县域溢出效应的类型以负向溢出为主;受溢出效应的空间格局和以负向溢出为主要类型的影响,京津冀县域经济水平类型发生转变的概率较小,经济水平较低的县域难以发生类型的转移,经济水平类型发生转移的县域多分布在地级以上城市市辖区的邻接地带;在邻接县域间显著的空间溢出效应作用下,相邻县域的经济水平类型的转移具有显著的同向性特征。     

浙江省县域经济格局的空间演化分析

基于浙江省67个县域的人均GDP,利用Arc GIS空间统计分析功能,分析2000—2013年间浙江省县域经济格局的空间演化的特征。结果表明:浙江省各县域人均国民收入存在正向的空间自相关;县域经济呈现西南—东北逐步增强的格局;2000—2013年间经济重心和格局比较稳定,略微向东北方向移动;冷热点分析和标准差椭圆也显示了不同县域之间存在分化。形成这种格局的原因包括第一自然的分异、产业集群的空间联系、政策红利的差异、区域规划的变化和国际经济环境的影响5个方面,并据此提出相应对策。     

老年人口健康的空间分异及影响因素研究——以湖北省为例

基于湖北省2010年人口普查和2015年人口抽样调查提供的103个县区的60岁及以上人口的自评健康数据,以老年健康率为地区老年人口健康水平的测度指标,分析了湖北省老年健康水平的时空格局及影响因素。结果表明：湖北省老年健康水平的空间分异显著,老年健康率的高值县区主要是地级市的市辖区,次高值县区主要集中在中部地域,低值县区则广布于省域边缘。湖北省老年健康水平呈现显著的空间正向关联性,但随着空间差异扩大,空间集聚程度呈下降态势。武汉城区及其周边为HH类型县区集聚区,鄂西、鄂东北和鄂东南边缘则是LL类型县区集聚区。总体上看,湖北省老年健康率的热点区域一直稳定地保持在武汉及其邻近县区,冷点区域也较为稳定地集中于鄂西、鄂东北和鄂东南边缘地区。除历史因素外,地区社会经济条件、自然环境因素以及老年人口社会经济特征的县际差异是湖北省老年健康水平空间分异的重要影响因素。该结果对于促进老年人口健康的区际公平发展具有借鉴意义。     

Take the edge off: A hybrid geographic food access measure

Measures of geographic food access overlook an important source of statistical biases, termed the edge effect. The edge effect refers to the fallacy that events contributing to the spatial pattern of an analysis unit may be outside of that unit; thus merely summarizing events within the unit may lead to distortion of the estimation. Food procurement activities can happen beyond existing administrative boundaries. Delineating food access using unit-based metrics may misrepresent the true space within which food stores are accessible. To overcome this problem, this paper proposes a gravity-based accessibility measure to improve unit-based statistical approaches in food access research. In addition, this method accounts for the spatial interaction between food supply (e.g., food items in stock) and demand (e.g., population) as well as how this interaction is mediated by the spatiotemporal separation (e.g., travel time, modality). The method is applied to the case of Franklin County, OH and has revealed the food access inequity for African Americans by modes of transport, including walking, biking, and driving. The analysis of the correlation between mode-specific food access and socioeconomic status (SES) variables reveals that using a single modality in food access research may not fully capture the travel behavior and its relationship with local food environments. With modifications, the proposed method can help evaluate food access for a target population group, such as Supplemental Nutrition Assistance Program (SNAP) users or selected ethnic minorities who may face acute difficulties in procuring economically affordable and culturally appropriate foods.     

欠发达地区经济空间结构及其经济溢出效应的实证研究--以河南省为例

以县域为基本空间单元,以人均GDP为衡量指标,分析了河南省经济空间结构演变过程,结果表明,20世纪90年代以来,河南省经济正处于空间集聚过程,经济空间结构呈现出明显的中心——外围模式。通过建立模型对河南省经济空间集聚格局的经济增长效应的分析表明,总体上河南省县域间经济增长的空间相关性不显著。只有在高水平县域集聚区,县域经济增长与相邻县域呈显著的正相关关系,表现出区域之间的经济溢出效应。     

Variation in low food access areas due to data source inaccuracies

Several spatial measures of community food access identifying so called “food deserts” have been developed based on geospatial information and commercially-available, secondary data listings of food retail outlets. It is not known how data inaccuracies influence the designation of Census tracts as areas of low access. This study replicated the U.S. Department of Agriculture Economic Research Service (USDA ERS) food desert measure and the Centers for Disease Control and Prevention (CDC) non-healthier food retail tract measure in two secondary data sources (InfoUSA and Dun & Bradstreet) and reference data from an eight-county field census covering 169 Census tracts in South Carolina. For the USDA ERS food deserts measure accuracy statistics for secondary data sources were 94% concordance, 50–65% sensitivity, and 60–64% positive predictive value (PPV). Based on the CDC non-healthier food retail tracts both secondary data demonstrated 88–91% concordance, 80–86% sensitivity and 78–82% PPV. While inaccuracies in secondary data sources used to identify low food access areas may be acceptable for large-scale surveillance, verification with field work is advisable for local community efforts aimed at identifying and improving food access.     

The Suburbanization of Food Insecurity: An Analysis of Projected Trends in the Atlanta Metropolitan Area

Although general patterns of food insecurity in the United States are known, few studies have attempted to estimate small area food security or account for ongoing socioeconomic changes. Here we address these issues by producing small area estimates of food insecurity in the Atlanta metropolitan area using two methodologies: fixed effects modeling and demographic metabolism. In both cases, we use county-level data from the Current Population Survey to determine the association between food insecurity and demographic predictors. These associations are then applied to tract-level data from the 2009 to 2013 American Community Survey and projected data for 2020 to create small area estimates of food insecurity. We find broad consensus between our two methods. For both time periods, food insecurity is highest in southern sections of the city of Atlanta and its neighboring suburbs. Projections to 2020, however, show that food insecurity rates are projected to increase in outer-ring suburbs east and west of the city while decreasing in the urban core. These results highlight the need to further adapt antihunger efforts for often sprawling suburban communities, where poverty rates are increasing but spatial mismatch combined with poor transit access might hinder access to food assistance.     

Food deserts? Healthy food access in Amsterdam

Healthy food environments are imperative for public health. Access to supermarkets that offer wholesome food products at low prices varies across space and over socioeconomic status and ethnic neighborhoods. This research examined food inequalities in Amsterdam, the Netherlands. Supermarket accessibility was calculated and linked to property prices and the share of native Dutch people on a geographic micro-scale with a spatial resolution of 100 meters. Mann–Whitney tests and Spearman correlations were used to test differences and associations between accessibility, property prices, and the share of natives per area. The spatially explicit contextual neural gas approach was used for data clustering. The results show access differences in supermarkets in favor of areas with high property prices and those areas with a large share of native Dutch people. The correlations indicate that low-priced areas and those with a low share of native Dutch people have a lower supermarket density, but the results are the opposite when proximity to and variety of supermarkets are examined. The clustering revealed no evidence of undersupplied areas. Pronounced inequalities in access to healthy food could not be confirmed. On the basis of this analysis, there is no urgent need for policymakers to intervene in the geographies of supermarkets.     

连片特困地区物流业发展的减贫效应测度

为科学测度连片特困地区物流业发展的减贫效应,基于熵权-TOPISIS模型对贫困程度进行评估,并以综合贫困指数为被解释变量,表征物流业发展水平的6个指标(货物周转量、物流业增加值、公路网密度、规模以上工业产值、社会消费零售总额和货物平均运距)为解释变量,引入空间杜宾模型(SDM)计量县域尺度下物流业发展对区域减贫的直接影响和空间溢出效应。研究表明：物流业增加值、路网密度和规模以上工业产值对区域减贫具有显著的直接效应,物流业增加值每增加10⁸元,本县(区)的综合贫困指数将降低0.060;货物周转量、公路网密度和规模以上工业产值对区域减贫的间接(空间溢出)作用明显,本县(区)货物周转量每增加10⁸ t·km^-1,毗邻县(区)的综合贫困指数将降低0.020。均衡物流产业的空间分布、完善物流基础设施和调动贫困县(区)物流需求,是发挥物流减贫效应的有效措施。     

基于县域单元的中国生态经济系统协调度及空间演化

以中国2853 个县(市、旗、区)为研究单元,利用1980、1990、2000 和2012 年的中国县级行政单元GDP数据和全国1 km格网土地利用数据,通过计算生态系统服务价值(ESV)和GDP的变化率,构建生态经济系统协调度(EEH)模型,分析了EEH的空间演化特征,在此基础上借助空间统计Local Moran's I 和Getis-Ord G_i^* 指数评价EEH空间分布模式.结果表明:①自1980 年以来中国县级行政单元GDP持续快速增长,全国呈现东南沿海增长速度明显高于中部地区,而中部地区又明显高于西部地区的特征;②生态系统服务价值(ESV)在空间分布上表现为西部和北部地区较高,南部和中东部地区较低;③中国县域EEH 1980-2012 年间逐步得到改善,EEH空间关联度总体相对稳定,但空间格局分布不均衡.总体来看,确保生态经济系统的持续协调发展的任务依然十分艰巨.     

省直管县改革背景下地级市空间溢出效应对县域产业结构的影响

地级市空间溢出效应对于县域产业结构产生重要影响,评估这种影响对于深化省直管县体制改革具有重要的理论和政策意义。在对河南省直管县体制改革历程及省直管县（市）特点进行分析的基础上,通过构建县域产业结构的计量模型,采用2004—2016年河南省县级单元的相关数据,研究了直管县体制改革带来的不同类型扩权以及省直管县（市）所在地级市溢出效应对于县域产业结构的影响,并通过省直管县（市）的深度访谈进行了验证。研究表明：① 经济管理权限的下放加快了县域第三产业的增长,而社会管理权限的下放则全面抑制了所有产业的产出水平。② 农业和非农产业受到所在地级市溢出效应的影响是相反的,经济管理权限的下放会加剧溢出效应。越是相对欠发达的县域,农业受到的涓滴效应越明显;越是相对欠发达的县域,非农产业受到的极化效应越明显,且第三产业比第二产业更为显著;③ 宜对更多县域下放经济管理权限,但对社会管理权限的下放则应慎重。地级市发展水平较高和较低的地区,应当分别选择农业比重较高的县域和非农产业发展基础较好的县域推进省直管县体制改革。     

Spatial Access to Health Care Services and Disparities in Colorectal Cancer Stage at Diagnosis in Texas

Early diagnosis of colorectal cancer (CRC) is important for improving the survival rate of the disease. Disparities in CRC diagnosis among different population groups have persisted in the United States. This study examines whether spatial access to medical services contributes to disparities of late-stage diagnosis of CRC in Texas. Analysis results suggest that there are significant disparities in late-stage CRC diagnosis by race/ethnicity, socioeconomic status, and geographic location in Texas. It is concluded that spatial access to primary care is associated with CRC stage at diagnosis, but not with racial/ethnic and socioeconomic disparities.     

Spatial and Longitudinal Patterns in County Age-Specific Net Migration in the United States 1950–2010

Many migration studies describe various counties by adopting a priori county typologies, such as the U.S. Department of Agriculture Economic Research Service county typology, which might not be suitable for identifying different age migration patterns of the U.S. counties. This study employs a spatial clustering method that exhaustively compares all U.S. counties on their age migration similarity and spatial proximity to investigate signature age-specific net migration profiles across six decades of U.S. county age-specific net migration data from 1950 to 2010. All of the six-decade data are integrated into a common spatial county boundary on which counties below a population threshold are merged with the nearest county to mitigate the small population problem in net migration rates. As counties are merged by increasing large population thresholds, the Getis-Ord Gi* spatial autocorrelation statistic is applied to examine how the spatial migration patterns are affected. It is found that U.S. county age-specific net migration profiles exhibit four signature patterns. Although these patterns are persistent across the past six decades, their spatial distributions have experienced dramatic variation. The small population problem in net migration rates affects the extent and location of the significant spatial migration patterns.     

黄河流域县域碳排放的时空格局演变及空间效应机制

利用空间面板模型、空间自相关分析和以区域背景与最近邻状况为空间滞后的空间马尔科夫链对2000—2017年黄河流域县域碳排放时空格局与空间效应进行分析,结果表明：① 2000年以来黄河流域碳排放量激增,由山东全域和陕甘宁蒙交界的高值区向外圈层与轴向扩张,形成东高西低碳排放格局;② 存在“俱乐部趋同”现象,高碳排放县集聚于山东全域和陕甘宁蒙交界,低碳排放县集聚于西南部;2000年与2017年对比发现县域碳排放类型稳定性强,较高碳排放变为较低碳排放的县集中在东南部区域,而相反方向转变的县集中在内蒙古;③ 高碳溢出效应与低碳锁定效应是塑造时空格局的重要作用力,前者作用力更强;区域背景增强了“俱乐部趋同”与被包围异常值趋同,作用力强于最近邻状况,不显著区域内碳排放类型转变概率提高。④ 空间面板模型结果显示年轻人口结构、大经济规模、二产为主产业结构、高生活水平和高公共支出促进了碳排放量增加与空间效应作用,其中经济规模与产业结构是重要驱动因素。     

Black–White and Hispanic–White Segregation in U.S. Counties

Residential segregation in metropolitan areas has been the subject of much research, but this article analyzes patterns of white–black and white–Hispanic segregation in counties across the United States. Our purpose was to understand county variations in this one dimension of inequality. Conceiving of segregation as relative inequality of access to neighborhood resources, we measured segregation in 2000 by the index of dissimilarity (D) calculated by blocks, mapped the index values, and correlated them with census variables. Three filters enabled us to eliminate counties with characteristics that could have corrupted the analyses, leaving us with more than 1,000 counties in each analysis. Both minority groups were less segregated from whites in the West and South and in metropolitan counties. Lower segregation was strongly associated with higher minority socioeconomic status and higher percentages of minorities living in housing built in the 1990s, and Hispanic–white segregation was lower where more Hispanics were U.S.-born or English proficient. The racial threat hypothesis was supported only weakly and inconsistently. Mapping made it possible to identify regional and local patterns of high and low segregation as well as the lower segregation of suburban counties in some large metropolitan areas.     

河北省长城沿线县域旅游产业集聚对经济增长的空间溢出效应研究

通过2015—2019年河北省长城沿线县域旅游产业集聚水平测算,归纳河北省长城沿线县域旅游集聚现状特征,并在地理权重矩阵的基础上采用探索性空间数据分析,探究各县域人均GDP的区域分异规律,运用空间计量经济学模型探讨县域旅游产业集聚对经济增长的空间溢出效应。结果表明：(1)河北省长城沿线县域的旅游集聚差异整体上呈现收敛态势;(2)人均GDP的空间正相关性显著,空间集聚度大体呈现稳中有降,且逐渐向均衡态势发展;(3)县域间人均GDP正向空间溢出效应明显;旅游集聚正向效应显著,是影响人均GDP的重要因素。基于以上分析提出相应建议,有利于县域间旅游经济活动的合作与竞争,对于长城的保护与传承也具有重要意义。